| ID | 178 |
|---|---|
| Name | FOOD POISONING |
| Cause | Causes of food poisoning:2 Non-toxin mediated- 1. Salmonella species (e.g s. typhi murium s. enteritidis) 2. Campylobacter jejuni 3. Bacillus cereus 4. Viruses e.g norwalk viruses 5. Listeria monocytogenes (causing meningitis) 6. Bacillus anthracis (anthrax) 7. Parasitic- amoebiasis, giardiasis. Toxin mediated- 1. Staph. aureus 2. Clostridium perfringens 3. Clostridium botulinum (botulism) 4. E. coli 0157 (enterohemorrhagic type 0157) |
| Signs Symptoms | |
| Diagnosis | Diagnosis: A. History- intake of contaminated food or drink (stated above). B. Mode of presentation- the simultaneous occurrence of symptoms in more than one member of a household or institution often simplifies diagnosis. The incubation period is a useful indicator. If vomiting starts within 30 minutes of ingestion of suspected food, it is likely to be due to a chemical poison; if it arises 12-48 hours later, it is probably due to salmonella or campylobacter infection. C. Investigation- a specimen of the patient’s stool or vomit together with the suspected food, if available, should be sent for culture. Organisms can usually be isolated. In severe cases blood should be sent for culture. |
| Investigations | |
| Management | Management: 1. During acute attack- no solid food. 2. Diet- liquid. 3. Oral rehydration therapy in mild to moderate cases. 4. In severely ill, collapsed or dehydrated cases require i.v. fluid therapy immediately. 5. When acute symptoms ceases, a semi-fluid low-roughage diet may be taken containing bread, butter eggs, fish, soft puddings and jellies. 6. Codeine phosphate or loperamide is useful in controlling diarrhoea. 7. Antibiotics- antibiotic should not be given routinely for acute diarrhoea and vomiting, but if- a. Salmonella bacteremia is suspected or confirmed or if diarrhoea is severe or prolonged- Ciprofloxacin 500mg twice daily 12 hourly; Or, Cotrimoxazole 960mg twice daily 12 hourly; Or, Trimethoprim 200mg twice daily 12 hourly should be given. All are for 7 days. b. For campylobacter enteritis- Erythromycin 250mg 6 hourly; Or, Ciprofloxacin 500mg twice daily 12 hourly, for 7 days, c. Listeria monocytogenes- Ampicillin is found effective, d. Amoebic infection- i. Metronidazole 400mg 3 times daily after food for 5-10 days; Or, Tinidazole or, omidazole both in doses of 2gm daily for 3 days; Or, Secnidazole Igm in single dose once only just before meal; Or, Nitazoxanide 500mg twice daily for 3 days, ii. Diloxanide furoate 500mg orally 8 hourly for 10 days after treatment, to eliminate luminal cysts, e. Giardia infection- i. Metronidazole 400mg 3 times daily after food for 10 days; Or, Tinidazole, a 2gm single dose Or, |
| Introduction | Food poisoning includes a number of disorders presenting with vomiting, diarrhoea, abdominal pain due to acute inflammation of the stomach and intestine (gastro-enteritis) within 48 hours of consumption of the contaminated food or drink. |
| History | |
| Etiology | |
| Clinical Features | Clinical features: 1. The principal symptoms are nausea, vomiting, diarrhoea (may be bloody) and abdominal colic. 2. In severe cases there may be prostration, collapse and dehydration. Patient may rapidly become shocked. 3. In the infection type, there is usually pyrexia and toxicity, patient may be ill for several days. 4. The stools are watery and offensive and may contain blood and some mucus. 5. Botulism- due to ingestion of toxin produced by cl. botulinum. The clinical features consist of vomiting and paresis of skeletal, ocular, pharyngeal and respiratory muscles. |
| Preventions | |
| Treatment | |
| Complications | |
| Prognosis | |
| Types | Food poisoning is usually divided into non-toxin type and toxin type. |
| Classification | |
| Observation | |
| Pathology |
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